Last week's call from NHS
regulator Monitor for NHS Trusts to fill only essential vacancies is very
worrying, even if, as later clarified, the advice is directed at non-clinical
staff as this has a knock-on effect on the whole workforce. Sadly this news
comes as no surprise to me. The National Health Action Party has
consistently been warning that the NHS is on a financial cliff edge and that
underfunding threatens to push it over. The £8bn that NHS CEO Simon
Stevens asked for, and George Osborne allocated in the summer budget, is
clearly inadequate as it is predicated on £22 billion of efficiency savings
that even senior figures at NHS England, as well as leading health think tanks,
now agree are unfeasible. The NHA Party gave fourteen separate warnings that
Mr Stevens' plans were unworkable.

What is particularly galling is that
Jeremy Hunt is now able to bat away calls for more funding by saying he has
given Mr Stevens everything he has asked for. Effectively, 'stop whingeing
and get on with it'. As if that's not bad enough, Mr Hunt is at the same time
demanding the NHS squeezes a fully operating seven day service out of an
already inadequate budget.

Research
shows that charging for services merely shifts costs to those who use
the system the most: sick people who tend to be the poor and the elderly. And evidence from Germany has
also proven that user fees hit socially deprived groups hardest and even a
small charge deterred patients from using health services. That's why they
ended up dropping the so-called Praxisgebuehr charge.

It is now clear that Mr Stevens has
got his sums wrong and underplayed the funding requirements for the NHS to
consistently deliver safe, effective and timely care. It
was reported that even on the day of the launch of the Five Year Forward
View, Mr Stevens and his team were still debating how much money they could get
away asking for. Any good negotiator knows you aim high in anticipation of
being knocked down – and you don’t claim you can make savings without being
100% sure that you can. Mr Stevens was reportedly
'disappointed' that a recent government-commissioned review of NHS
productivity identified only £5bn of potential savings. Disappointed? The
head of the NHS was a staggering £17bn out in his 'efficiency savings'
calculations. This is totally unacceptable and will have drastic consequences
for the NHS.

Set up to fail?

It appears Mr Stevens has dug a hole
for himself and the NHS in failing to negotiate a workable deal. When you
juxtapose the growing severity of the NHS financial crisis and the now open
calls to look at alternative funding models for the NHS with Mr Stevens'
previous post as president of the global health division of UnitedHealth
Group, a giant US private healthcare company, some people may ask: Is the NHS
being set up to fail?

Mr Stevens said in his 5 Year Forward
View that "the NHS is the proudest achievement of our modern
society". If he wants to be seen as the torch-bearer for our NHS he must
openly acknowledge that the £8bn request was wholly insufficient and have the
courage to call for increased NHS funding to a level that ensures the
continued survival of a safe, effective and public NHS.

About the author

Clive Peedell is a cancer specialist, member of the BMA council, and co-founder and co-leader of the National Health Action Party.

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